OXACILLIN - oxacillin sodium injection, powder, for solution 
Sandoz Inc
Oxacillin for Injection, USP
PHARMACY BULK PACKAGE – NOT FOR DIRECT INFUSION
To reduce the development of drug-resistant bacteria and maintain the effectiveness of Oxacillin for Injection and other antibacterial drugs, Oxacillin for Injection should be used only to treat or prevent infections that are proven or strongly suspected to be caused by bacteria.
DESCRIPTION
Oxacillin for Injection, USP is a semisynthetic antibiotic substance derived from 6-amino-penicillanic acid. It is the sodium salt in a parenteral dosage form for intramuscular or intravenous use. The pharmacy bulk package contains oxacillin sodium monohydrate equivalent to 10 grams oxacillin. It also contains approximately 2.5 mEq of sodium and 20 mg dibasic sodium phosphate (as a buffer) per gram of oxacillin.
OXACILLIN SODIUM

C19H18N3NaO5S • H2O                MW=441.43
4-Thia-1-azabicyclo [3.2.0]heptane-2-carboxylic acid, 3,3-dimethyl-6-[[(5-methyl-3-phenyl-4-isoxazolyl) carbonyl] amino]-7-oxo-,monosodium salt, monohydrate, [2S(2α,5α,6β)].
A pharmacy bulk package is a container of a sterile preparation for parenteral use that contains many single doses. The contents of this pharmacy bulk package are intended for use by a pharmacy admixture service for addition to suitable parenteral fluids in the preparation of admixtures for intravenous infusion. (See DOSAGE AND ADMINISTRATION, Directions For Proper Use of Pharmacy Bulk Package).
FURTHER DILUTION IS REQUIRED.
CLINICAL PHARMACOLOGY
Microbiology
Penicillinase-resistant penicillins exert a bactericidal action against penicillin-susceptible microorganisms during the state of active multiplication. All penicillins inhibit the biosynthesis of the bacterial cell wall.
The drugs in this class are highly resistant to inactivation by staphylococcal penicillinase and are active against penicillinase-producing and nonpenicillinase-producing strains of Staphylococcus aureus.
The penicillinase-resistant penicillins are active in vitro against a variety of other bacteria.
Susceptibility Plate Testing
Quantitative methods of susceptibility testing that require measurement of zone diameters or minimal inhibitory concentrations (MIC’s) give the most precise estimates of antibiotic susceptibility. One such procedure has been recommended for use with discs to test susceptibility to this class of drugs. Interpretations correlate diameters on the disc test with MIC values. A penicillinase-resistant class disc may be used to determine microbial susceptibility to cloxacillin, dicloxacillin, methicillin, nafcillin, and oxacillin. With this procedure, employing a 5 microgram methicillin sodium disc, a report from the laboratory of “susceptible” (zone of at least 14 mm) indicates that the infecting organism is likely to respond to therapy. A report of “resistant” (zone of less than 10 mm) indicates that the infecting organism is not likely to respond to therapy. A report of “intermediate susceptibility” (zone of 10 to 13 mm) suggests that the organism might be susceptible if high doses of the antibiotic are used, or if the infection is confined to tissues and fluids (e.g. urine), in which high antibiotic level